Premium
The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence
Author(s) -
Huang Zhengzheng,
Fonseca Ricardo,
Sharman James E.,
Park Chloe,
Chaturvedi Nish,
Howe Laura D.,
Hughes Alun D.,
Schultz Martin G.
Publication year - 2020
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.13645
Subject(s) - medicine , blood pressure , cardiology , body mass index , physical fitness , cardiovascular fitness , lean body mass , mass index , cardiac function curve , physical therapy , body weight , heart failure
Purpose Exaggerated exercise blood pressure (BP) is associated with altered cardiac structure and increased cardiovascular risk. Fitness modifies these associations, but the effect in healthy adolescents is unknown. We performed an observational study to determine the influence of fitness on post‐exercise BP, and on its relationship with cardiac structure in adolescents. Methods 4835 adolescents from the Avon Longitudinal Study of Parents and Children, (15.4 (0.3) years, 49% male) completed a submaximal cycle test. Fitness was estimated as physical work capacity 170 adjusted for lean body mass and post‐exercise BP measured immediately posttest. Cardiovascular structure and function, including left ventricular (LV) mass (n = 1589), left atrium (LA) size (n = 1466), cardiac output (CO, n = 1610), and total peripheral resistance (TPR, n = 1610) were measured at rest by echocardiography 2.4 (0.4) years later. Results Post‐exercise systolic BP increased stepwise by fitness tertile (131.2 mm Hg [130.4, 132.1]; 137.3 mm Hg [136.5, 138.0]; 142.3 mm Hg [141.5, 143.1]). Each 5 mm Hg of post‐exercise systolic BP was associated with 2.46 g [1.91, 3.01] greater LV mass, 0.02 cm [0.02, 0.03] greater LA size, and 0.25 g/m 2.7 [0.14, 0.36] greater LV mass index. Adjustment for fitness abolished associations (0.29 g [−0.16, 0.74]; 0.01 cm [−0.001, 0.014] and 0.08 g/m 2.7 [−0.001, 0.002]). Similar associations between post‐exercise systolic BP and each outcome were found between the lowest and highest fitness thirds. CO increased with fitness third (difference 0.06 L/min [−0.05, 0.17]; 0.23 L/min [0.12, 0.34]) while TPR decreased (difference −0.13 mm Hg·min/L [−0.84,0.59]; −1.08 mm Hg·min/L [−0.1.80, 0.35]). Conclusions Post‐exercise systolic BP increased with fitness, which modified its association with cardiac structure. Higher CO, but lower TPR suggests a physiologically adapted cardiovascular system with greater fitness, highlighting the importance of fitness in adolescence.